Historically, adolescents have been difficult to reach for preventive medical care, including immunization. Because a number of new vaccines and new uses of existing vaccines now target adolescents, the development of effective strategies to immunize this age group is critical, and is emerging as an area of great interest for a variety of communities. This study will investigate the relationship between the immunization of adolescents and the delivery of other preventive services to adolescents 11-18 years of age. Specifically we will determine current rates for delivery of both immunizations and other recommended clinical preventive services (CPS). We will examine immunization- and CPS-related attitudes and prioritization among physicians who care for adolescents, and look at the relationships between the delivery of each type of service. These observations will be stratified by age (11-14 and 15-18 years), provider type (pediatrician vs. family practice), clinic type (HMO, private practice, community health center, and public health center), clinic location, and vaccine. We will also look at perception and understanding of the adolescents and their parents regarding preventive services received. The results from these investigations will facilitate the planning of strategies to enhance the delivery of both immunizations and other recommended preventive services to adolescent populations. Specific Goals 1. Evaluate the knowledge, attitudes, and experiences of pediatricians and family practitioners regarding delivery of immunizations and other clinical preventive services (CPS) to adolescents through the use of in- depth key informant interviews. 2. Determine how pediatricians and family practitioners prioritize immunizations and other CPS recommendations for adolescents through the use of in-depth key informant interviews. 3. Establish a baseline rate for delivery of target vaccines and selected age-appropriate CPS and determine the relationship between the deliveries of these two services. 4. Survey parents and adolescents to document the receipt of immunizations and the receipt and understanding of CPS. 5. Survey parents and adolescents to determine the proportion of adolescents stratified by age that seek care from providers other than pediatricians and family physicians. For those cared for by these other provider types determine the degree to which immunizations or CPS are delivered in these settings. This study will help determine if receipt of the new immunizations for adolescents, ages 11-18, is associated with receipt of other recommended preventive health services for this age group, and will provide the basis of strategies for improving their delivery. [unreadable] [unreadable] [unreadable]